Abstract
An innovative biomechanical procedure for preparing bone for dental implant placement is called osseodensification. The current study evaluated the bibliometric attributes of the research performance on osseodensification. We utilized the osseodensification database that we obtained from the Scopus, Web of science, PubMed, ScienceDriect, and Cochrane Library databases to perform retrospective bibliometric study. The data was searched during April 16, 2024, with the search term “Versah” OR “Densah” OR “Osseodensification”. We identified 114 records on the Scopus database, 88 records on Web of Science, 90, 54 and 62 records on PubMed, ScienceDirect and Cochrane Library, respectively. After applying inclusion/exclusion criteria, removed the duplicate and irrelevant records (n = 286), and 122 articles were considered for analysis. The year of publications with citations, publishing channels, top contributing countries, institutions, authors, authorship patterns and the attributes of top-10 most cited articles were quantified from the bibliometric parameters of the articles. For the data analysis, Microsoft Excel (v.16) software (Redmond, Washington) was applied. A bibliometric analysis of 122 osseodensification research articles published between 2016 and 2024 revealed key trends. The United States was the leading contributor, followed by Brazil and Italy. The International Journal of Oral & Maxillofacial Implants (n = 9) and Implant Dentistry (n = 74.20 citations/article) were the most prolific journals. While the United States had the highest number of articles (n = 46), Romania demonstrated the highest citation impact per article (27.80 citations/article). Collaboration between institutions, particularly between two, was associated with the highest citations. Most authors contributed to a single article, with an average of nearly five authors (4.79) per article. Rodrigo Neiva was identified as the most prolific author. The top 10 most-cited articles accounted for almost half (48.56%) of all citations. Osseodensification is a potential procedure in implant dentistry with promising prospects for improving implant success rates.
Keywords: Bibliometric, Densah, Implant dentistry, Osseodensification, Versah
Introduction
Branemark (Brinemark et al. 1981) developed the concept of osseointegration, defined as the direct contact between living bone and the surface of a load-bearing implant, which improved the treatment of individuals who were either fully or partially edentulous.(Brinemark et al. 1981; Slete et al. 2018; Adell et al. 1981; Albrektsson et al. 1981; Abraham 2014) The traditional method of preparing the implant site involves utilizing conical or cylindrical drills which can cut and remove the bone in order to place the implant afterwards. (Bertollo and Robert 2011 (One of the most crucial elements of implant success is primary stability, which is influenced by the implant's geometry, type, surgical technique, and bone density. (Jarikian et al. 2021; Oliveira et al. 2018) For evaluating implant stability and osseointegration, techniques including Resonance Frequency Analysis (RFA), Periotest, and insertion torque can be utilized. (Huwais and Meyer 2017; Al-Jetaily and Al-dosari 2011; Kanathila and Pangi 2018).
Following tooth extraction, the alveolar ridge dimensions at the edentulous site are reduced (Pai et al. 2018; Mello Machado et al. 2018) resulting in insufficient alveolar bone remaining. As a result, a variety of procedures, including alveolar ridge augmentation, ridge splitting and maxillary sinus elevation, have been developed to enhance insufficient alveolar bone, either simultaneously with or prior to implant placement. (Abraham 2014; Lopez et al. 2017).
Replacing conventional bone subtractive methods, Huwais S. presented osseodensification, an atraumatic osteotomy preparation technique, in 2013. (Jarikian et al. 2021) osseodensification has been developed to replace conventional bone subtractive drilling in order to enhance bone density, bone volume percentage, and bone-to-implant contact, all of which contribute to increase implant stability. (Pai et al. 2018) By employing a Densah bur, we can induce a controlled compression force during drilling, resulting in predictable bone deformation. This method capitalizes on the viscoelastic and viscoplastic characteristics of bone. (Mello Machado et al. 2018) This procedure can increase the implant's primary and secondary stability as well as the percentage of bone-implant contact (BIC) by up to three times when compared to the traditional subtractive drilling technique (Mello Machado et al. 2018). The preservation of bone volume, faster healing since the bone matrix is protected, and regular replacement of the autogenous bone graft matrix along the implant surface are among the main advantages of this technique. (Mello Machado et al. 2018) By centrifugally densifying the drilled osteotomy site via non-subtractive drilling, osseodensification enhances primary stability in contrast to standard drilling techniques. (Lopez et al. 2017) Thus, this method is beneficial for sub-antral bone grafts, narrow bone crest expansion, post-extraction implants, and cases of poor bone density type IV in the posterior maxilla. (Mello-Machado et al. 2021; Rosa et al. 2019).
Bibliometric analysis is a quantitative tool for assessing and evaluating scientific publications (Garfield 1986; Koskinen et al. 2008), which can provide significant insights into the distribution and progress of research activity. (Debackere and Glänzel 2004; Lewison and Devey 1999) For example, Alqahtani et al. conducted a bibliometric analysis of Periodontics Research in Saudi Arabia, which has shown tremendous growth in recent years, due to increased international collaboration, particularly with researcher from the United States. (Alqahtani and Haq 2023) To the best of our knowledge, no previous studies have used bibliometric analysis to assess the research performance of osseodensification, providing valuable insights into the top contributing countries, institutions, authors, authorship patterns, and characteristics of the top ten most cited articles. Therefore, this study aimed to carry out a detailed bibliometric analysis on all articles produced regarding osseodensification.
Materials and methods
Study design and ethical approval
This study was designed as a bibliometric network analysis. The study was exempted from obtaining an institutional review board (IRB) ethical approval due to the analysis of publicly available data.
Data bases and keywords
We performed quantitative bibliometric investigation using the Scopus dataset, Web of science, PubMed, ScienceDirect and Cochrane library searched on April 16, 2024, with the search term “Versah OR Densah OR Osseodensification”. We retrieved the dataset 114 articles from the Scopus, 88 records from Web of science database, PubMed, ScienceDriect and Cochrane library provided the records of 90, 54, and 62 records, respectively. Afterward, we implemented exclusion criteria by removing 286 records, resulting in 122 articles were considered for analysis (Fig. 1).
Fig. 1.
Screening process of articles
Inclusion and exclusion criteria
We included peer-reviewed scientific literature, such as original research articles, review articles, and case reports, in our analysis with the search term “Versah OR Densah OR Osseodensification” and papers were screened to confirm relevance, while excluding less-cited sources like conference abstracts, editorials, and letters to the editor.
Analysis
Microsoft Excel (v.16) software (Redmond, Washington) was employed for the data analysis.
Variables of interest
The study investigated several key features, including the distribution of articles and citations by year, the list of the most frequently used journals, the most productive countries and institutions, the most prolific authors, authorship patterns, and the top most cited articles.
Results
A total of 122 articles were selected and these articles were published from 2016 to May 2024 and these articles gained 2,156 citations with an average of 17.67 citations per article. The articles published in 2016 gained highest ratio of citations (205.67 cites/article), while the recent articles published in 2024 gained the lowest citation impact (Table 1), (Fig. 2).
Table 1.
Distribution of articles and citations by year
| Year | Documents | Citations | Citation Impact |
|---|---|---|---|
| 2024 | 9 | 2 | 0.22 |
| 2023 | 25 | 77 | 3.08 |
| 2022 | 28 | 129 | 4.61 |
| 2021 | 20 | 313 | 15.65 |
| 2020 | 9 | 215 | 23.89 |
| 2019 | 19 | 460 | 24.21 |
| 2018 | 8 | 343 | 42.88 |
| 2017 | 1 | 0 | 0.00 |
| 2016 | 3 | 617 | 205.67 |
Fig. 2.
Distribution of articles and citations by year
The selected 122 articles published in 66 journals, and one article each was published in 41 journals. The list of top-10 frequently used journals shown in (Table 2). The highest number of articles (n = 9) was published in The International Journal of Oral & Maxillofacial Implants, followed by Applied Science. The articles published in Implant Dentistry gained the highest citation impact (74.20 cites/article), followed by The International Journal of Oral & Maxillofacial Implants (IJO&MI) with 41.33 cites/article.
Table 2.
List of top-10 frequently used journals
| Serial No | Name of Journal | Impact factor JCR-2022 | Total Documents | Total Citations | Citation Impact |
|---|---|---|---|---|---|
| 1 | The International Journal of Oral & Maxillofacial Implants | 2.0 | 9 | 372 | 41.33 |
| 2 | Applied Sciences | 2.7 | 7 | 67 | 9.57 |
| 3 | Implant Dentistry | 3.0 | 5 | 371 | 74.20 |
| 4 | Clinical Implant Dentistry and Related Research | 3.6 | 4 | 87 | 21.75 |
| 5 | Journal of Oral Biology and Craniofacial Research | Not indexed in Web of Science | 4 | 80 | 20.00 |
| 6 | Journal of Clinical Medicine | 3.9 | 4 | 6 | 1.50 |
| 7 | Journal of Osseointegration | 0.4 | 4 | 3 | 0.75 |
| 8 | The Journal of Indian Prosthodontic Society | 1.2 | 3 | 93 | 31.00 |
| 9 | Materials | 3.4 | 3 | 90 | 30.00 |
| 10 | The Journal of Craniofacial Surgery | 0.9 | 3 | 88 | 29.33 |
The authors belonged to 32 countries contributed in 122 articles and authors from 13 countries had contributed in a single article, while the authors from four countries contributed in two articles. The authors of top-15 countries contributed the maximum 46 articles to minimum three articles, as shown in (Table 3). More than one third (n = 46; 37.70%) of the articles produced by the United States, followed by Brazil (n = 24; 19.67%) and India (n = 23; 18.85%). The highest citation impact (27.80 cites/article) gained by articles contributed by the Romania, followed by United States (25.54 cites/article), Brazil (24.33cites/article) and Italy (24.29 cites/article).
Table 3.
Top-15 most productive countries
| Rank | Countries | Total Papers | Total Citations | Citation Impact |
|---|---|---|---|---|
| 1 | United States | 46 | 1267 | 27.54 |
| 2 | Brazil | 24 | 584 | 24.33 |
| 3 | India | 23 | 238 | 10.35 |
| 4 | Egypt | 15 | 120 | 8.00 |
| 5 | Italy | 14 | 340 | 24.29 |
| 6 | Saudi Arabia | 7 | 90 | 12.86 |
| 7 | Spain | 7 | 61 | 8.71 |
| 8 | Romania | 5 | 129 | 25.80 |
| 9 | Chile | 4 | 94 | 23.50 |
| 10 | Uruguay | 3 | 52 | 17.33 |
| 11 | Canada | 3 | 29 | 9.67 |
| 12 | Iraq | 5 | 48 | 9.60 |
| 13 | Portugal | 5 | 36 | 7.20 |
| 14 | Russia | 3 | 19 | 6.33 |
| 15 | France | 3 | 8 | 2.67 |
A total of 195 institutions/research organizations belonged to 32 countries of the world contributed in 122 articles and three-fourth (n = 144; 73.84%) of the institutions had contributed single paper followed by two and three papers by 33 and 9 institutions, respectively. The researchers of New York University contributed the highest number of articles (n = 13) followed by University of Florida and University of Pennsylvania with ten and seven articles, respectively. The articles contributed by University of Minnesota gained the highest citation impact (75.00 cites/article). Out to top-10, six universities belonged to the United States, followed by two universities from Brazil and one each from Iraq and Egypt. The private dental practitioners contributed in 14 articles and these articles gained 118 citations with an average of 8.43 citations per article (Table 4).
Table 4.
Top-10 most productive institutions
| Serial No | Name of Institutions | Total Articles | Total Citations | Citation Impact |
|---|---|---|---|---|
| 1 | New York University, United States | 13 | 649 | 43.23 |
| 2 | University of Florida, United States | 10 | 537 | 57.90 |
| 3 | University of Pennsylvania, United States | 7 | 68 | 9.71 |
| 4 | University of Minnesota, United States | 6 | 450 | 75.00 |
| 5 | University of Sao Paulo Brazil | 5 | 325 | 65.00 |
| 6 | Federal University of Santa Catarina, Brazil | 5 | 143 | 28.60 |
| 7 | University of Baghdad, Iraq | 5 | 48 | 9.60 |
| 8 | Al-Azhar University, Egypt | 4 | 5 | 1.25 |
| 9 | University of Michigan, United States | 4 | 2 | 0.50 |
| 10 | Nova Southeastern University, United States | 3 | 80 | 26.67 |
The author(s) belonged to single institution contributed in 48 articles, and these articles gained 422 citations with an average of 8.79 cites/article, while authors belonged to two institution contributed in 25 articles, these articles gained 686 citations with an average of 27.44 cites/articles. Fifteen articles contributed by the authors of three institutions and these articles gained 253 citations with an average of 16.86 cites/articles and in 34 articles the authors affiliated from more than three institutions contributed and these articles gained 771 citations with an average of 22.64 cites/article. Therefore, it is found that the collaboration of two institutions gained more citation impact as compared to other institutional collaboration patterns.
A total of 585 authors, including multiple counts contributed in 122 articles, with an average of 4.79 authors per articles. Two-thirds (n = 389; 66.49%) of the authors had contributed single article. Rodrigo Neiva affiliated to the University of Florida and University of Pennsylvania contributed the highest number of articles (n = 14), followed by Paulo G Coelho and Nick M Tovar with 11 and 10 articles, respectively. Two authors, Adham M. Aligarag of New York University & SUNY Upstate Medical University and Estevam A Bonfante of University of Sao Paulo, emerged as most influential authors based on citation impact (Table 5).
Table 5.
Top-10 most prolific authors
| Serial No | Author’s name | Affiliation | Total Articles | Total Citations | Citation Impact |
|---|---|---|---|---|---|
| 1 | Rodrigo Neiva | University of Florida & University of Pennsylvania | 14 | 96 | 6.86 |
| 2 | Paulo G Coelho | New York University | 11 | 89 | 8.09 |
| 3 | Nick M Tovar, | New York University | 10 | 82 | 8.20 |
| 4 | Lukasz Witek | New York University | 9 | 73 | 8.11 |
| 5 | Salah Huwais, | University of Minnesota | 7 | 33 | 4.71 |
| 6 | Adham M. Alifarag, | New York University & SUNY Upstate Medical University | 4 | 35 | 8.75 |
| 7 | Estevam A Bonfante, | University of Sao Paulo | 4 | 35 | 8.75 |
| 8 | Christopher D Lopez, | New York University | 4 | 34 | 8.50 |
| 9 | Luiz F. Gil | University of Pennsylvania & Federal University of Santa Catarina | 4 | 34 | 8.50 |
| 10 | Andrea Torroni, | New York University | 4 | 27 | 6.75 |
The analysis of authorship patterns revealed only seven articles written by single authors while 94.26% (n = 115) of the articles were written by multi-author. Three and four author patterns were found preferred with 19 articles each, while the articles written by more than seven authors gained the highest citation impact (33.06 cites/article) followed by two-author pattern (25.88 cites/article). The lowest citation impact was recorded against single author articles (Table 6).
Table 6.
Authorship patterns
| Serial No | Authorship Pattern | Total Articles | Total Citations | Citation Impact |
|---|---|---|---|---|
| 1 | Single Author | 7 | 33 | 4.71 |
| 2 | Two-Author | 18 | 466 | 25.88 |
| 3 | Three-Author | 19 | 241 | 12.68 |
| 4 | Four-Author | 19 | 357 | 18.78 |
| 5 | Five-Author | 15 | 163 | 10.86 |
| 6 | Six-Author | 12 | 210 | 17.50 |
| 7 | Seven-Author | 17 | 190 | 11.17 |
| 8 | More than Seven Author | 15 | 496 | 33.06 |
About half of the citation (n = 1047; 48.56%) have been gained by top-10 most cited articles with an average of 104.7 citations per article, as shown in (Table 7). These articles published between the year of 2016 and 2021 and four articles published in the year 2018, followed by three articles in 2016. These articles published in seven different journals and three articles published in Implant Dentistry, followed by two articles in The International Journal of Oral & Maxillofacial Implants. The authors belonged to seven countries contributed in these articles and most of the articles (I = 8) were contributed by the United States, followed by two each from Brazil and India, while one each was contributed by Chile, Italy, Sweden and Romania.
Table 7.
Top-10 most cited articles
| Serial No | Description of article | Total Citations | Citation Density by year (Rank) |
|---|---|---|---|
| 1 | Huwais S, Meyer EG. A Novel Osseous Densification Approach in Implant Osteotomy Preparation to Increase Biomechanical Primary Stability, Bone Mineral Density, and Bone-to-Implant Contact. Int J Oral Maxillofac Implants. 2017 Jan/Feb;32(1):27–36 | 251 | 31.38 (1) |
| 2 | Trisi P, Berardini M, Falco A, Podaliri Vulpiani M. New Osseodensification Implant Site Preparation Method to Increase Bone Density in Low-Density Bone: In Vivo Evaluation in Sheep. Implant Dent. 2016 Feb;25(1):24–31 | 203 | 25.38 (2) |
| 3 | Lahens B, Neiva R, Tovar N, Alifarag AM, Jimbo R, Bonfante EA, Bowers MM, Cuppini M, Freitas H, Witek L, Coelho PG. Biomechanical and histologic basis of osseodensification drilling for endosteal implant placement in low density bone. An experimental study in sheep. J Mech Behav Biomed Mater. 2016 Oct;63:56–65 | 163 | 20.38 (3) |
| 4 | Alifarag AM, Lopez CD, Neiva RF, Tovar N, Witek L, Coelho PG. Atemporal osseointegration: Early biomechanical stability through osseodensification. J Orthop Res. 2018 Sep;36(9):2516–2523 | 71 | 11.83 (6) |
| 5 | Huwais S, Mazor Z, Ioannou AL, Gluckman H, Neiva R. A Multicenter Retrospective Clinical Study with Up-to-5-Year Follow-up Utilizing a Method that Enhances Bone Density and Allows for Transcrestal Sinus Augmentation Through Compaction Grafting. Int J Oral Maxillofac Implants. 2018 Nov/Dec;33(6):1305–1311 | 65 | 10.83 (8) |
| 6 | Pai UY, Rodrigues SJ, Talreja KS, Mundathaje M. Osseodensification—A novel approach in implant dentistry. J Indian Prosthodont Soc. 2018 Jul-Sep;18(3):196–200 | 62 | 10.33 (9) |
| 7 | Slete FB, Olin P, Prasad H. Histomorphometric Comparison of 3 Osteotomy Techniques. Implant Dent. 2018 Aug;27(4):424–428 | 59 | 9.83 (10) |
| 8 | Padhye NM, Padhye AM, Bhatavadekar NB. Osseodensification – A systematic review and qualitative analysis of published literature. J Oral Biol Craniofac Res. 2020 Jan-Mar;10(1):375–380 | 59 | 14.75 (5) |
| 9 | Koutouzis T, Huwais S, Hasan F, Trahan W, Waldrop T, Neiva R. Alveolar Ridge Expansion by Osseodensification-Mediated Plastic Deformation and Compaction Autografting: A Multicenter Retrospective Study. Implant Dent. 2019 Aug;28(4):349–355 | 58 | 11.60 (7) |
| 10 | Bergamo ET, Zahoui A, Barrera RB, Huwais S, Coelho PG, Karateew ED, Bonfante EA. Osseodensification effect on implants primary and secondary stability: Multicenter controlled clinical trial. Clin Implant Dent Relat Res. 2021 Jun;23(3):317–28 | 56 | 18.67 (4) |
Discussion
We investigated the evolution of research published in osseodensification over a span of 8 years (2016–2024) using an inclusive analytical bibliometric approach. Our findings demonstrate interesting results, as articles were published from 2016 to May 2024 gained 2,156 citations with an average of 17.67 citations per article. The articles published in 2016 gained highest ratio of citations (205.67 cites/article), while the recent articles published in 2024 gained the lowest citation impact, which could be attributed to the fact that citation rates usually go up gradually.
The present study holds significant importance as it offers useful data to assess the progress of osseodensification research. It enriches our comprehension of the present state of osseodensification in implant dentistry. The International Journal of Oral & Maxillofacial Implants appears to be the preferred journal for osseodensification research, as it have the highest number of articles. However, Implant Dentistry published the most impactful research, followed by The International Journal of Oral & Maxillofacial Implants. This is partially explained by the fact that osseodensification may be of great interest to the audience of these journals, whom the author intends to target.
Despite the global nature of osseodensification research, our findings reveal a concentration of research output in the United States. More than a third of the analyzed articles (37.70%) originated from the US, confirming their position as a leading contributor in this field. Brazil and India followed closely behind, representing 19.67% and 18.85% of the articles respectively. However, citation quantity does not always represent research production, thus we focused on the countries with the highest citation effect. While the US produced the most articles, Romania takes the lead with the highest average citations per article (27.80). The US follows closely with a 25.54 citation per article average. This suggests that although the US is a prolific producer of research, other countries may be producing particularly influential work in the field of osseodensification.
Interestingly, the United States dominated the landscape, with six out of the top ten institutions being American. New York University, University of Florida, and University of Pennsylvania were particularly active, contributing the most articles. However, the University of Minnesota had the highest impact, as evidenced by the number of citations per article. The study also evaluated the role of collaboration on citation impact and indicated that collaboration between two universities gained more citation impact than other institutional collaboration patterns. Notably, Rodrigo Neiva from the University of Florida and University of Pennsylvania authored the most articles, while Adham Aligarag and Estevam Bonfante emerged as the most influential based on citations. Therefore, the study highlights the leading role of US institutions and showcases the valuable contributions of both individual researchers and collaborative teams.
The analysis of authorship patterns underscores the prevalence of collaboration in research with only a small fraction of articles (7 out of 122) authored by a single researcher. The study emphasizes the value of researcher collaboration. Interestingly, while publications with three or four authors were the most common, those with more than seven co-authors received the highest citation impact (33.06 citations per article). This suggests that larger study groups may foster a more impactful exchange of ideas. It is also worth noting that two-author publications had a higher citation impact (25.88 citations per article) than single-authored papers, underscoring the value of collaboration.
The analysis of citations reveals a concentration of impact within a select group of highly influential articles, 48.56% of all citations represent top 10 papers with an impressive average of 104.7 citations per article. Although all of these papers were published between 2016 and 2021, four of them appeared in 2018, followed by three in 2016. In addition, the top-10 most cited articles originated from a geographically diverse group of authors, across seven countries. However, the United States lead the list with the most contributions (8 articles), followed by Brazil and India (2 articles each). This pattern highlights the international nature of impactful research while acknowledging the prominence of US institutions. It is important to note that the most prominent articles were published across many different journals, with Implant Dentistry taking the lead with three publications, followed by The International Journal of Oral & Maxillofacial Implants with two articles.
This study has several limitations. First, the reliance on specific keywords for article identification may have resulted in the exclusion of relevant studies that did not use those terms. Further studies using a broader keyword could reveal a deeper knowledge of the osseodensification research output. Second, we included all published articles from several dataset, Scopus dataset, Web of science, PubMed, ScienceDirect and Cochrane library, However, other documents published in gray literature may include relevant findings. Thus, future research utilizing several datasets and grey literature will be beneficial. Third, the study was mainly quantitative, with an emphasis on numerical data rather than examining the methodological quality of individual research. Therefore, further research examining the quality of published studies on osseodensification will be worthwhile.
Conclusion
Osseodensification presents a promising approach in implant dentistry with the potential to enhance implant success. This bibliometric analysis revealed a remarkable growth of research on osseodensification in implant dentistry, with significant contributions from the United States and the international collaboration.
Acknowledgements
None.
Authors contributions
HA, IH and NA contributed to conception, design, data acquisition, drafted, and critically revised the manuscript. IH contributed to analysis and interpretation. All authors gave final approval and agreed to be accountable for all aspects of the work.
Data availability
Not applicable.
Declarations
Ethical policy and institutional review board statement
The King Abdullah International Medical Research Center Institutional Review Board exempted this study since it does not involve human subjects or relevant data (# NRR24/022/6).
Declarations of interest
None.
Financial support and sponsorship
None.
Informed consent
For this type of study, formal consent is not required.
Patient declaration of consent
Not applicable.
Conflicts of interest
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. The authors report no conflicts of interest related to this study.
Footnotes
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Data Availability Statement
Not applicable.